老年营养风险指数对非ST段抬高型急性冠状动脉综合征病人经皮冠状动脉介入术后院内主要心血管不良事件的预测价值  

Predictive value of the Geriatric Nutritional Risk Index for in-hospital major adverse cardiovascular events after PCI in patients with NSTE-ACS

作　　者：姬燕 杨荣礼 JI Yan;YANG Rongli(College of Graduate,Xuzhou Medical University,Xuzhou,Jiangsu 221004,China;Department of Geriatrics,The Affiliated Hospital of Xuzhou Medical University,Xuzhou,Jiangsu 221004,China)

机构地区：[1]徐州医科大学研究生院,江苏徐州221004 [2]徐州医科大学附属医院老年医学科,江苏徐州221004

出　　处：《安徽医药》2023年第6期1224-1227,共4页Anhui Medical and Pharmaceutical Journal

摘　　要：目的 探讨老年营养风险营养指数(GNRI)对非ST段抬高型急性冠状动脉综合征(NSTE-ACS)病人经皮冠状动脉介入术(PCI)后发生院内主要心血管不良事件(MACE)的预测价值。方法 回顾性收集2019年12月至2021年6月徐州医科大学附属医院收治的经PCI治疗的NSTE-ACS病人360例,根据病人术后是否发生MACE,分为MACE组48例和非MACE组312例。比较两组间临床资料、实验室检查结果的区别。应用多因素logistic回归分析评估发生MACE的危险因素。应用受试者操作特征(ROC)曲线及Delong检验评估GNRI,全球急性冠状动脉事件注册积分(Grace评分)对MACE的预测价值及差异。结果与非MACE组相比,MACE组年龄(75.50±5.37)岁、Grace评分(168.00±32.50)分显著高于非MACE组(69.95±5.21)岁、(139.02±22.59)分,GNRI(95.97±7.33)显著低于非MACE组(103.75±10.47)(P<0.05)。多因素logistic回归分析显示,低GNRI、Grace评分增加及年龄增加是NSTE-ACS病人发生MACE的危险因素(均P<0.05)。ROC分析显示,GNRI、Grace评分和两者联合预测MACE发生的曲线下面积分别为0.74、0.77、0.81(均P<0.05)。进一步使用Delong检验对GNRI及Grace评分的ROC曲线进行比较,结果显示差异无统计学意义(Z=0.73,P=0.468)。结论 GNRI是发生院内MACE的重要影响因素,术前GNRI水平对NSTE-ACS病人PCI术后发生院内MACE具有一定的预测价值。Objective To investigate the predictive value of the geriatric nutritional risk index(GNRI)on the occurrence of in-hospital major adverse cardiovascular events(MACE)after percutaneous coronary intervention(PCI)in patients with non-ST segment elevation acute coronary syndrome(NSTE-ACS).Methods A total of 360 patients with NSTE-ACS treated by PCI admitted to the Affiliated Hospital of Xuzhou Medical University from December 2019 to June 2021 were retrospectively collected and divided into the MACE group(n=48)and the non-MACE group(n=312)according to whether the patients had MACE after the procedure.The differences in clinical data and laboratory test results were compared between the two groups.Multivariate logistic regression analysis was applied to evaluate the risk factors for the occurrence of MACE.Receiver operating characteristic(ROC)curve and Delong method were used to evaluate the predictive value and difference of GNRI,Global Registry of Acute Coronary Events score(Grace score)on MACE.Results Compared with the non-MACE group,the MACE group had a significantly higher age(75.50±5.37)and Grace score(168.00±32.50)than the non-MACE group(69.95±5.21 and 139.02±22.59,respectively)and a significantly lower GNRI(95.97±7.33)than the non-MACE group(103.75±10.47)(P<0.05).Multivariate logistic regression analysis showed that low GNRI,increasing GRACE score and increasing age were risk factors for the development of MACE in patients with NSTE-ACS(P<0.05).ROC analysis showed that the area under the curve for the GNRI,GRACE score and both combined to predict the occurrence of MACE was 0.74,0.77,and 0.81(P<0.05),respectively.Further comparison of the ROC curves for the GNRI and Grace score using the Delong method showed no statistically significant difference(Z=0.73,P=0.468).Conclusion The GNRI is an important influencing factor for the occurrence of in-hospital MACE,and the preoperative GNRI level has predictive value for the occurrence of in-hospital MACE after PCI in patients with NSTE-ACS.

关 键 词：急性冠状动脉综合征 老年营养风险营养指数 全球急性冠状动脉事件注册积分 心血管不良事件 经皮冠状动脉介入术 血清白蛋白 

分 类 号：R541.4[医药卫生—心血管疾病]